A Farewell to Legs

The end is near!  I mean, like it is done - my school career in leg making has come to a close.  Insane.  I am not sure how it went by so quickly...I blinked and went from my first cast to laminating this last leg. After getting the lamination done, I trimmed my socket out and I was so excited about the way it looked!  The inner liner came out just as it was supposed to and having a pattern on the socket really makes it much cooler in my opinion.  When you are spending hours with this leg, getting to put a little bit of creativity and fun into it puts a smile on your face.  Everything about making a leg is about following a pattern, following a specific body or bone or alignment - getting to jazz it up and make it fun is more about you as a practitioner, and typically, most specifically about your patient.  As I mentioned earlier, these legs were about us because we were the ones taking them home, but hopefully in the future, my patients and I see eye to eye on all of the fun stuff we can do with their sockets :)

I put a different pattern on the inside of the leg and was actually pleasantly surprised by how cool it came out as far as looks goes, but I did manage to miss a few spots with the resin and therefore it was just some patches of soft fabric on the inside as opposed to all hard and glossy and smooth like it was supposed to be.  Oops.  Time for prosthetic problem solving - a little adjustment to the trimlines and a little extra fiberglass and resin and I was good to go.  Rookie mistake - I can guarantee you I will not "under-resin" ever again!!  What would school be if not for making mistakes and learning from them?  

After I got the socket smoothed and sanded down and dropped the outer hard layer down so the inner flexible liner would have room to actually be flexible, I was able to gunk on the components.  This part is always a little stressful to me because it has to be in the right angle and flexed and all of that, it just seems so final.  The flip side of that being that it IS final...and that means you are at the end of the leg making stage - attaching the components is just tightening a few screws!  (My professors would kill me for saying that, clearly there is much more that goes into it.)

Now it becomes one of those cooking shows where they magically have everything already prepared before starting and they just keep throwing ingredients in and pulling out beautifully cooked dishes.  I did a little gunking and fiberglassing and voila - here is my completed leg!  Everything attached and everything working and now I just need a patient to make it walk back and forth.  I always feel like a leg that stands up on its own is a good sign - at least I know it is all level to begin with.  So, this is all ready and good to go for Paul's arrival - I just need him to bring his shoes and a good attitude and hopefully some extra energy to do some walking.  Critiques for these last projects are supposed to be much shorter and much easier than the previous ones because with transfemoral sockets, it is mainly the socket fit that causes the problems, not as much the alignment.  And, according to our professors, will all of our alignment practice this semester (all 12 weeks thus far), we were not going to focus too much on that during critique.  And since we had all been able to make at least two sockets for these current patients, in an ideal world, our sockets should have been fitting pretty nicely.

The key phrase in that last statement being "ideal world."  Despite my addiction of the silicone pad and taking off a lot of plaster before creating this second socket, my socket was still a little too big on Paul.  It was not crazy, a simple pad made it much better, but I was surprised it was still big with the amount of material that I had added and taken off after the test socket.  Paul is also a little on the fleshy side and tends to go nuts with his diet (McDonalds for breakfast before the last fitting, chocolate cake for midnight snack this time around) and so it is hard to predict what his body is going to do in response to his diet.  Too much salt and he is swollen, one skipped meal and he is dropping down in size.  This is a common issue with a lot of patients so definitely something I will see again...good thing I love a challenge :)  So, here I am on critique day, proudly displaying my finished leg and dressed to impress.  My critique went well, Paul walked around and overall, the fit, like I said, was not horrible.  It is so crazy that this was my last big project of school and that I am going to be graduating in four weeks!!  We do a couple of upper extremity things in the next couple of weeks, but nothing really major like these legs we have been making.  It is all coming to an end quickly.  

Because of the finality of the project, it was a big picture day at school - they even had professional photographers in capturing it all.  Everyone was feeling very accomplished and very pleased with themselves and it was fun to have everyone feeling relaxed and proud and taking a moment to celebrate our accomplishments so far.